Nurses Have a Prescription for the Democratic Party: Back Single Payer

Democratic voters overwhelmingly support Medicare for All, yet not all Democratic candidates do.

May 3, 2018

Members and supporters of National Nurses United rally for a single-payer national health insurance program in the US. (Sipa USA via AP)

Ready to join the resistance?

Sign up for Take Action Now and we’ll send you three actions every Tuesday.

You will receive occasional promotional offers for programs that support The Nation’s journalism. You can read our Privacy Policy here.

Thank you for signing up. For more from The Nation, check out our latest issue.

Subscribe now for as little as $2 a month!

Support Progressive Journalism

The Nation is reader supported: Chip in $10 or more to help us continue to write about the issues that matter.

Fight Back!

Sign up for Take Action Now and we’ll send you three meaningful actions you can take each week.

You will receive occasional promotional offers for programs that support The Nation’s journalism. You can read our Privacy Policy here.

Thank you for signing up. For more from The Nation, check out our latest issue.

Travel With The Nation

Be the first to hear about Nation Travels destinations, and explore the world with kindred spirits.

Sign up for our Wine Club today.

Did you know you can support The Nation by drinking wine?

When the Democratic Party’s platform committee rejected a proposal for finally establishing a single-payer health-care system in the United States, Michael Lighty of National Nurses United reminded them that 81 percent of Democrats tell pollsters they support a “Medicare for All” reform. “If [single payer] is controversial in this room, it is the only room of Democrats in which it is controversial,” the veteran union activist explained.

Lighty was right, and, though his position did not prevail that day, he promised that “the 185,000 registered nurses of National Nurses United will not give up on their patients. They will not give up until we assure health care for all. They will not give up until we have Medicare for All.”

Unfortunately, the persistent determination of the Democratic Party’s hypercautious “strategists” and “leaders” to reject the will of Democratic voters—and the historical traditions of a party that declared in its 1948 platform: “We favor the enactment of a national health program”—continues.

This reticence is practically and politically unnecessary, as the party’s potential presidential contenders have recognized. One-third of Senate Democrats now back the single-player legislation advanced by Vermont Senator Bernie Sanders, including 2020 prospects Elizabeth Warren of Massachusetts, Kamala Harris of California, Cory Booker of New Jersey, Jeff Merkley of Oregon, and Kirsten Gillibrand of New York.

Despite the fact that Democrats who are thinking seriously about the future are moving on the issue, there are still too many top Democrats who pull their punches, refusing to embrace a reform that is at once needed and popular.

Most Popular

Current Issue

Kucinich’s approach to the health-care debate is much bolder than Cordray’s.

“Health care ought to be a basic right in a democratic society. The affordability and availability of health care is essential to the quality and length of life. Any society worthy of the support of its people ought to provide health care for all. The fact that quality health care is generally available depending on income compromises our humanity, makes health-care peons of hardworking Americans, and drives millions of people to the brink of poverty and hampers economic growth by placing a financial burden on small businesses,” says the former mayor of Cleveland, who asks Ohioans to: “Imagine a health-care system which contributes to the health of all of its people, the prosperity of its businesses and industries, and is not hamstrung by insurance companies.”

That system, says Kucinich, “should be a not-for-profit, single-payer system. One fund, one plan, and one single payer, because it is the simplest and most efficient approach to the administration of health-care resources. This does not mean government-run hospitals and long lines. It means there is one agency or organization within state government paying the bills and enjoying the reduced costs by cutting out middlemen.”

This week, the National Nurses Organizing Committee affiliate of National Nurses United (NNOC/NNU) endorsed Kucinich, wading into the Ohio race as part of the broader struggle for single payer that in 2016 saw the nurses’ union play a pivotal role in Sanders’s bid for the Democratic presidential nomination. (NNU’s California section, the California Nurses Association, is playing a major role in that state’s June 5 gubernatorial primary, in which it is backing Lieutenant Governor Gavin Newsom, the Democratic front-runner. In Maryland’s June 26 Democratic gubernatorial primary, NNU is backing former NAACP president Ben Jealous, who says, “As Governor, I will work for a Medicare For All system in Maryland because I believe it is the best way to support families and small businesses who continue to pay more and more for a healthcare system that provides less and less each year.”)

As a mayor, state legislator, congressman, and, most recently, commentator on Fox News, Ohio’s Kucinich has established a record of taking bolder and more controversial stances than most prominent Democrats. That unsettles some Democratic strategists, who worry openly about his electability. But the nurses like what they’re hearing from the candidate on health-care issues—and they’re betting that a lot of Democratic and independent voters feel the same way.

Citing Kucinich’s plan to develop a single-payer system in Ohio, Rhonda Risner, RN, a member of NNOC/NNU from Dayton, said: “The current system is not working for large numbers of Ohioans. Almost 650,000 people in Ohio have no health insurance whatsoever and tens of thousands more have insurance with deductibles and co-pays so high they cannot afford to see a doctor or seek hospital care when they need it. This is a key reason why we need Dennis Kucinich as our next governor so we have a real leader in Columbus who will enact a real solution to this crisis.”

Alright John! I am a Progressive and a big Kucinich fan and contributor. Ohio is at the same crossroads that was presentented in 2016, a selection of establishment or true Progressive. Hopefully Ohio will pull it's behind out this time.

(3)(0)

Francis Louis Szotsays:

May 6, 2018 at 4:04 pm

The ONE policy item still missing is a program to mitigate the turnover that is expected to happen when all of those current "middlemen" get cut out of the new system.

Throw–in some type of employment preference for those already in the industry, and it might reduce plenty of the opposition from entrenched interests, at least at the level of the wage–earning working people. If not that, do something intelligent and compassionate in this regard.

(2)(0)

Susan Bentonsays:

May 4, 2018 at 4:39 pm

I agree with Charles Pack. Our current healthcare system is simply unsustainable, especially since Trump has been quietly and slowly defunding it. The only real solution
is universal healthcare. Yes, I’m aware that a lot of people believe
universal healthcare is too expensive, but I’ve been trying to educate myself about it and I have
concluded that it’s not true. Granted,
it will take some very smart people to set it up properly. The “it’s too
expensive” crowd is buying the false narrative being peddled by people who don’t want to tie-up or dedicate
that much money. Why don’t they want to tie-up that money? It’s because these people want to have it available so they can get their hands on it. When Obama was still president I found a very long list of
things that could be done by our government to save a substantial amount of money. It was produced by the Office of Management and
Budget. (I don’t know if it’s still available on the internet.) Some of the ways listed would not have been
agreed to by one party or the other,
but that still left literally dozens of other ways. First, our tendency is to analyze this issue the same way we analyze our household budget but that is a mistake. it’s much more complex. Second, although we have
a different situation than countries in Europe who have universal care
that doesn’t mean we can’t look to those systems for guidance in order to pick & choose what is appropriate
for America. Thirdly, we are the wealthiest nation in the world. What
has happened for the last several decades is a complex system of funneling money away from the middle class and to the wealthy. Trump’s tax scam has done that to a spectacular degree. It was a classic “bait & switch” scam. Fourthly, we have been giving billions of dollars
away in the form of corporate subsidies and grants EVERY year.
The American people never hear
much about that and we are not asked if we want to continue doing it. Those subsidies need to be analyzed to determine if they are still appropriate. Fifth, our tax dollars have been paying anyway for people who don’t have insurance
and it is the most expensive way to get that healthcare we pay for.
People without insurance typically don’t try to get healthcare until the
problem escalates to the point of going to the ER. Sixth, Just as Pres. Obama did, there are small taxes that can be charged relatively painlessly as a minor cost of doing business. My example of a possible way to do this is to charge for each Wall St. trade. There is a class of trades that occur every day that drives the market up all day until
just before closing. Then at the close of the trading day they quickly get sold to make a profit which then drives the market back down. That’s not good for our economy and it
makes the market more unstable. If a small tax is added to each of those trades it might put a damper on that activity and that would be helpful
for economic stability. The taxes on those trades could go into the budget for universal healthcare. That’s just one example. There are many more. In fact an often overlooked aspect of Obamacare is that it was structured in a way that paid down our debt & deficit. And it did actually pay down our debt.
Seventh, healthcare costs can be negotiated way down because Universal healthcare provides
leverage for getting those costs down. Eighth, Trump is already defunding Obamacare. At some point pretty soon the healthcare sector will be in total chaos because
Trump is cutting off funds without
any alternative programs in place.
In summary, we can have universal
healthcare and I’m willing to bet it will be less expensive than what we have now. Certain people don’t want
us to believe that for their own selfish reasons. Obamacare didn’t ruin our economy. It actually helped
it. There are more aspects to it but
there isn’t enough space to write about it here.

(12)(0)

Alan Backmansays:

May 4, 2018 at 2:53 pm

(Cont'd)
Sure, liberals retort that people would still come out ahead relative to the premiums they would no longer need to pay. But again, people just don't buy this argument. And that's the liberal problem generally. For 50 years, liberals have basically been Marxists promising more benefits that neither the beneficiaries nor most people would need to pay for (e.g. Obamacare). "From those with the greatest ability to those with the greatest need." And that's popular. Why not be generous when someone else is picking up the check ?

But it's got several problems. First, it's very different from Europe where everyone (including the poor) pay a pretty similar (high) tax rate. And everyone uses the resulting services. Liberals in the US havn't been able to persuade the average person to pay an additional dime since Medicare - 50 years ago. And the problem is that the things they are promising now (like single payer) are just so expensive, that you can't get there without taxing everyone.

(1)(9)

Alan Backmansays:

May 4, 2018 at 2:53 pm

"81 percent of Democrats tell pollsters they support a “Medicare for All” reform." That's not quite true ... or rather, people only say they want Single Payer before they understand that they may actually need to pay for it ! See link below. Single payer is favored 39 to 33 generally. But when asked if they would whether they favor single payer if their taxes would increase, support craters to 28 to 39.
https://www.theatlantic.com/health/archive/2016/02/people-have-no-idea-what-single-payer-means/471045/

(0)(6)

Alan Backmansays:

May 4, 2018 at 2:53 pm

"81 percent of Democrats tell pollsters they support a “Medicare for All” reform." That's not quite true ... or rather, people only say they want Single Payer before they understand that they may actually need to pay for it ! See link below. Single payer is favored 39 to 33 generally. But when asked if they would whether they favor single payer if their taxes would increase, support craters to 28 to 39.
https://www.theatlantic.com/health/archive/2016/02/people-have-no-idea-what-single-payer-means/471045/

Same thing happened in CA (and other liberal states) when people found that it would cost them an increase of 15% of their payroll taxes.
https://www.vox.com/policy-and-politics/2017/5/22/15676782/california-single-payer-health-care-estimate

Sure, liberals retort that people would still come out ahead relative to the premiums they would no longer need to pay. But again, people just don't buy this argument. And that's the liberal problem generally. For 50 years, liberals have basically been Marxists promising more benefits that neither the beneficiaries nor most people would need to pay for (e.g. Obamacare). "From those with the greatest ability to those with the greatest need." And that's popular. Why not be generous when someone else is picking up the check ?

But it's got several problems. First, it's very different from Europe where everyone (including the poor) pay a pretty similar (high) tax rate. And everyone uses the resulting services. Liberals in the US havn't been able to persuade the average person to pay an additional dime since Medicare - 50 years ago. And the problem is that the things they are promising now (like single payer) are just so expensive, that you can't get there without taxing everyone.

(1)(8)

Charles Packsays:

May 4, 2018 at 1:26 pm

The current healthcare system is unsustainable. It already takes too much of our economy. It is also growing faster than any other segment. We must cut high-overhead insurance companies out of the delivery of basic healthcare. They could still serve a role in "enhanced" features.

(9)(1)

Alan Backmansays:

May 4, 2018 at 2:55 pm

Health insurers do not make up a large percentage of health costs. Health insurance is expensive in this country because healthcare is expensive.

(0)(9)

Mary Bell Lockhartsays:

May 4, 2018 at 1:17 pm

Nichols isn't telling it true here. The argument within the Democratic Party is not those opposed to vs in favor of single-payer health insurance. Single-payer being the ultimate goal; the argument is about what is best to do NOW, where is the greatest NEED, and what is the best MODEL to pursue going forward. Millions of Americans have employer-supplied health insurance. More millions have Medicare, but it is not completely single-payer because a) they pay for it and b) they carry supplemental private insurance through their employment or retirement programs. They (and I include myself in that number) are very satisfied with with those health care payment plans. So satisfied are they that Sanders acknowledges he used the phrase "Medicare for All" because it would resonate, not because it's the best model. Still, at the moment there is no great need to tamper with those two provision of health care funding (lowering the age of eligibility for Medicare would help). The greatest need now is in serving the rest our our population through expansion of Medicaid as widely as possible and preserving availability and affordability for those who get assistance through the ACA Advanced Premium Tax Credits. It's our middle and low income citizens who should be the focus right now. Raise the quality and the funding of Medicaid, expanded it in the states where it has not been expanded, make Medicaid a "public option." We can't get there with Nichols plan of moving the entire health care funding in one swoop to everyone on single-payer. That's been tried and failed. His rhetoric is needlessly divisive and suggests we lay the baby of our entire health care system on the altar where it will be killed as it was before. While he's out here yammering "Medicare for All or Bust" the Trumpublicans have enacted short-term insurance plans that undercut the funding of all forms of health insurance by taking some insured out of the pool thus raising the costs for everyone else. Focus on the real world, the now, and the people who are in most need first.

(4)(8)

Elizabeth Gioumousissays:

May 7, 2018 at 2:56 pm

Not so many people are happy with employer healthcare any more. Co-pays, deductibles, if you actually get sick you pay a lot. People think they have good coverage until they need it.

And grand sweeping campaigns are good politics. Democrats have been losing, dramatically, with cautious, tinkering around the edges politics. Medicare for all, debt free college, Fight for 15, all those are ways we can win again, as well as being morally right. It isn't Bernie, fighting for Medicare, who has enabled Trumpcare, it's the timid ones who won't fight. And Clintoncare and Obamacare both ruled out single payer right from the start - many of us feel that's why we got nothing the first time and a Republican plan the second time.

(4)(0)

Gretchen Brinsersays:

May 7, 2018 at 12:25 am

Single-payer was never "tried" in the USA and therefore has never "failed"; what on earth do you mean by that? Saying it don't make it so. It's b/s to affirm that employer-provided insurance leaves beneficiaries "very satisfied"--many, many people are unhappy with employee plans which keep being scaled back and/or requiring larger employee contributions for minimal and restricted services. Not to mention the enormous burden of premiums on employers, especially smaller employers, and the burden of billing on health care providers. This is the real world; if you really want to help those in most need, get on board.

(3)(0)

Clark M Shanahansays:

May 4, 2018 at 2:18 pm

So blocking a single payer option off of the 2016 Dem platform was just being pragmatic?

(4)(2)

Clark M Shanahansays:

May 4, 2018 at 1:57 pm

You make a fine apologist for the DNC.
Tanden's CAP Medicare for All proposal in response to Sanders original plan is a total sellout.
Disingenuous as most Third Way solutions are.

It's part of GOP dogma: use malign neglect to get rid of the "47% takers" (some 150 million fellow Americans) while generating a profit for connected people and businesses. It makes the Final Solution look like the work of a piker.

(6)(0)

Carla Skidmoresays:

May 4, 2018 at 12:02 pm

Why, oh, why is our once progressive nation so far behind other advanced nations that say that Health Care Is a Right, not a mere privilege for the few?

(15)(0)

Alan Backmansays:

May 4, 2018 at 2:58 pm

I can't tell if your question is rhetorical ? The answer as to why the US is "behind" other nations is that other nations tax their citizens similalry mainly using something called a VAT tax (like a sales tax). Again, EVERYONE pays it. But liberals in the US have been so accustomed to giving more services but not charging the recipients (or even most people) a dime, that they are simply afraid of asking more taxes from the broad public in return for more services.

(0)(5)

Susan Bentonsays:

May 4, 2018 at 4:59 pm

Um, no. The reason we don’t have universal healthcare is because of greedy politicians who have wealthy donors contributing to
their campaigns. That way the wealthy get even more money by
politicians rigging the system in favor of businesses, corporations & the wealthy and the politicians
can keep getting elected because
they have more money to spend on their campaigns. It won’t change until we get money out of
campaigns. It has thoroughly corrupted our government. Trump’s tax scam is the perfect example. Remember how republicans in Congress said they had to pass this tax law because they had to pay back their donors? Guess what, the middle class is paying off those donors
against their will via a hike in middle class taxes written into Trump’s tax law. You aren’t seeing it yet because you were fooled by
the meager drop in taxes for the middle class at the beginning of
trump’s tax scam. In a couple of years our tax rate will go way up
because the tax law that was just passed is designed that way. The argument that we are giving too much money away in welfare etc.
is just scapegoating, so republicans can blame the poor for what they,the republicans, have created. Check it out for yourself and don’t believe the BS you are being fed.

(10)(0)

Alan Backmansays:

May 5, 2018 at 9:41 pm

And if the prior link is too complex for you, here's Matt Yglesias, one of the most venerated liberal voices (on Vox) explaining why single-payer is hard to pay for.
"But fundamentally, any single-payer health insurance program is going to cost a lot of money because health insurance pays for health care and health care is expensive — particularly in the United States, where it amounts to 16 percent of the overall economy."
"To finance it (at least if you want to abide by budget reconciliation rules) you need to pair it with a big tax increase. Some of that can be taxes on the rich. But the program is so big that it mostly has to be funded with a broad tax like the payroll tax that funds Social Security or the Value Added Tax (VAT) that funds most big European welfare state programs."
Again, learn something and help us all.
https://www.vox.com/policy-and-politics/2017/7/10/15932446/how-to-pay-for-single-payer

(0)(3)

Francis Louis Szotsays:

May 6, 2018 at 4:12 pm

This person (Alan B.) is guilty over and over of committing a lie of omission.

An enormous part of the cost of the single–payer program is recouped by the obvious fact that private insurance premiums will no longer be charged.

Now, if people do not understand that simple fact, it's just a matter of consistent education. But when guys (like Alan) refuse to mention it, it amounts to a lie; a lie of omission.

(3)(0)

Alan Backmansays:

May 5, 2018 at 9:38 pm

Are you really equating campaign finance to health insurance premiums ? See link below and educate yourself. This shows the tax and income system in Scandinavia (which liberals like Sanders love). They mainly have public financing of campaigns. And single payer healthcare. But you'll see (that as I asserted), their tax system which finances their expenses (like healthcare is quite flat) meaning that everyone pays roughly the same tax rate.
https://taxfoundation.org/how-scandinavian-countries-pay-their-government-spending/

(1)(2)

Clark M Shanahansays:

May 4, 2018 at 9:26 am

What Gives?
Our Third Way leadership is playing coy right through to the elections, while consistently swift-boating any candidate that questions Wall Street and/or the Pentagon.
Then you have Tanden's CAP presenting an ersatz Medicare for All to muddy the water; giving cover to the party's foremost pimps..
amusing: "Being a capitalist probably hurt me"

Kudos to the nurses, who witness our screwed up system and speak out every day.
Their red sweatshirts were a welcome, integral part
of the great Bernie rally.

(14)(2)

Richard Phelpssays:

May 3, 2018 at 7:46 pm

The neoliberal Democrats want to keep getting the big money donations from insurance companies. That is their priority over health care for all. So sick, that they can be called “democrats “.

(16)(2)

Ken Sandinsays:

May 4, 2018 at 12:58 pm

Exactly right. When WAMU/NPR's Dianne Rehm asked Stephen Brill why not, if Medicare is the low-cost insurer, just move everyone to Medicare, he said it was because of the enormous lobbying power of the insurance and pharmaceuticals industries. I'm disappointed in John Nichols for missing this and writing instead about hypercautious Democratic leaders.

(4)(0)

Clark M Shanahansays:

May 4, 2018 at 2:11 pm

one reality does not preclude the other..
But the DNC isn't being cautious, they're just being their natural pimps.

(5)(1)

Karin Eckvallsays:

May 3, 2018 at 7:17 pm

Democratic leadership isn't just "reticent" and "unsupportive" of single payer/Medicare for All. Dianne Feinstein is trying to frighten people by claiming it represents "a government takeover" of health care. That's almost as bad as Hillary sending Chelsea on the campaign trail to tell people that they and their children would lose their health insurance under M4A, without bothering to mention that it would simply replace their insurance...with something better.

It is long past time for these corporate Dem "incrementalists", who have enriched themselves with money and power beyond measure by preserving the status quo, to go. The stench is killing us.